Effect of functional electrical stimulation plus body weight-supported treadmill training for gait rehabilitation in patients with poststroke: a retrospective case-matched study

Eur J Phys Rehabil Med. 2020 Feb;56(1):34-40. doi: 10.23736/S1973-9087.19.05879-9. Epub 2019 Oct 15.

Abstract

Background: Functional electrical stimulation (FES) plus body weight-supported treadmill training (BWSTT) provide effective gait training for poststroke patients with abnormal gait. These features promote a successful active motor relearning of ambulation in stroke survivors.

Aim: This is a retrospective study to assess the effect of FES plus BWSTT for gait rehabilitation in patients poststroke.

Design: A retrospective case-matched study.

Setting: Participants were recruited from a rehabilitation department in an acute university-affiliated hospital POPULATION: Ninety patients poststroke from Yue Bei People's Hospital underwent BWSTT (A: control group) were compared to an equal number of cross-matched patients who received FES plus BWSTT (B: FES plus BWSTT group).

Methods: While B group received FES for 45 minutes plus BSWTT for 30 minutes in the program, group A received time-matched BWSTT alone. The walking speed, step length, step cadence, Fugl-Meyer Lower-Limb Scale (LL-FMA), composite spasticity scale (CSS), 10-Meter Walk Test (10MWT), Tinetti Balance Test (TBT) and nerve physiology testing were collected before and after intervention.

Results: One hundred and eighty patients with poststroke abnormal gait were chosen. There were significant differences in walking speed, step length, step cadence, LL-FMA, CSS, TBT, and 10MWT between baseline and postintervention (P<0.05). There were significant differences in walking speed, step length, step cadence, LL-FMA, CSS, TBT, and 10MWT between two groups at the end of the eighth week (P<0.05), but not at baseline (P>0.05). In comparison with group A, the peak of somatosensory evoked potential (SEP) and motor evoked potential (MEP) amplitude increased, the latency was shortened, and the conduction velocity of sensory nerve (SCV) and motor nerve (MCV) was significantly increased in the group B (P<0.05). No adverse events occurred during the study.

Conclusions: This study suggests that FES plus BWSTT could be more effective than BWSTT alone in the improvement of gait, balance, spasticity, and function of the lower limb in patients poststroke.

Clinical rehabilitation impact: Introduce effective rehabilitation strategies for poststroke patients with abnormal gait.

MeSH terms

  • Aged
  • Combined Modality Therapy
  • Disability Evaluation
  • Electric Stimulation Therapy / methods*
  • Female
  • Gait Disorders, Neurologic / physiopathology*
  • Gait Disorders, Neurologic / rehabilitation*
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stroke / physiopathology
  • Stroke Rehabilitation / methods*
  • Walk Test